Thank you so much.
Thank you for the invitation and the opportunity to speak at this meeting of the House of Commons Standing Committee on Health.
My name is Isaac Bogoch. I’m an infectious diseases physician and scientist based out of the University of Toronto and the Toronto General Hospital. I have worked closely with various levels of government in both a formal and informal capacity during this pandemic.
As we trudge forward somewhat exhausted from the last two years, it's still appropriate to acknowledge that COVID is not going anywhere any time soon, and we will see an ongoing waxing and waning of disease activity in Canada and also in communities around the world, and this is, of course, going to be associated with morbidity and mortality, unfortunately. COVID is obviously a global issue, but I'm going to focus my talk locally.
With that in mind, how do we plan ahead so that Canadian society is not disrupted significantly by future waves or variants? Or, said another way, how do we live with COVID? By “live with COVID”, I mean how do we protect all Canadians, including and especially vulnerable individuals and at-risk communities?
I’m approaching this with the understanding that we should never close businesses or schools again. We have the tools to avoid this. This involves being proactive and not getting caught flat-footed.
I see two main pillars that we should be addressing. Pillar one is building resilient health care systems, and pillar two is really fostering resilient communities and environments.
Just focusing on the first one, building a COVID-resilient health care system, this really involves proactive vaccine and therapeutics procurement and perhaps production. We saw early on that our inability to produce these products locally was a true health security threat, and now we're taking steps to remedy this, but we still need momentum on that front.
Related to vaccine and therapeutic procurement is vaccine and therapeutic rollout to the population. We have to continue to be nimble and fast with policy to be able to keep abreast of emerging evidence in real time and convert this evidence into sound policy. It also means rolling out vaccines and therapeutics in an evidence-based and equitable manner with as few barriers as possible. That might seem abstract, but a good example of this is how, in parts of the United States, they're going to roll out COVID treatments at some pharmacies. Pharmacies are present in most neighbourhoods and are staffed with knowledgeable health care professionals; they often don’t require an appointment, and they're often more accessible than traditional routes for health care. COVID therapeutics at pharmacies without a prescription is just one of an infinite number of examples of how we can lower barriers to health care and provide fast, meaningful high-quality health care to populations.
The other big issue in the health care system is preparing for surge capacity. This involves outpatient care, hospital care and, of course, ICU care. We will see more variants. We will see more waves, and eventually we are going to have a real flu season coupled with COVID, and it’s going to be a challenge. We can’t continue to cancel scheduled surgeries every time we have a wave and our system is stretched. It's vital to have medium and long-term strategies to build more beds and to staff them, not just with doctors but also with allied health care providers. This involves meaningful investments making the health care sector a more attractive place to work, and, of course, less red tape preventing skilled health care providers who have trained in other countries and are now living in Canada from working.
Let's focus our attention now on building more resilient populations and environments. It's easy to say, hard to do. The lowest hanging fruit is normalizing mask use during COVID surges. This is a light-touch intervention, and while, of course, masking is not perfect, it still helps the individual, it helps vulnerable people, it helps the community and I think it's about as easy as it gets.
An additional strategy is further study on how we can build safer indoor spaces. This is where COVID and other respiratory viruses transmit. That, for example, includes improving indoor air quality. This involves an interdisciplinary approach with social scientists, engineers, infection specialists, building owners, building managers and others. It’s not just as simple as installing HEPA filters.
Last, I think an area for improvement includes enrolling social scientists, behavioural change experts and communications experts into the larger pandemic plans. We are going to continue to see rapid scientific advancements. We're going to see variants, we're going to see waves, we're going to see a fair bit of the unknown. Policy has to be data driven and relevant, and it has to keep up with our lightning pace of discovery. Some of what's true now may not be true in the near future. We need public trust and public buy in. Behavioural scientists and communications experts can help communicate change and adaptation and communicate the unknown in an age, language, and culturally appropriate manner. I think they'd be invaluable in our future pandemic response.
I have several other thoughts and I'm happy to keep the conversation going during the question period. Thank you for your time.